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Would you go ahead with a Prostate removal?
Long story... 69 year old Male
I've had a enlarged Prostate for a few years....PSA has been as high 16's and as low as 5.27 on finasteride.
3 biopies the last one MRI-computer guided they only found a couple small lesions but no cancer... that was 2 years ago
July this year in the middle of the night..I couldn't pee... went to the ER
they did the optilume processor and catheterized me and sent me home...3 days later they removed the catheter and that night I stopped peeing again....Back to the ER..back in went the catheter..this time 7 days in.... 2 day after removal I couldn't pee back to the ER
and I went to see my Doc within a week..They taught me to self catheter until I could see the surgeon ... I catheterized a couple times and then I just said nope..lets wait and see and it was fine, no problems for a 10 days...Saw the Surgeon he set up my next appointment for Oct 7th..for all the test...
He does the robotic..removal through your penis Yikes...lol
So I've only had to catheterized one time in the last 3 weeks but I do get blood once in a while and I think maybe it was a clot that caused that...
My question is this.... Since everything seems to be working and if it does stop I know how to self-catheterize ...Should I go to the extreme and remove the prostate..if they don't find cancer on the 7th..I mean I don't know if they are looking or doing a MRI or ?..
I just feel like maybe I'm going to far and maybe the end results will be worse then the present problem..which other than maybe stop peeing, there isn't nothing new.
One other kicker.........I've hit my Out of Pocket max with my INS..so this would be 100% paid......LOL jeeezzz
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@bajjerfan Sorry for confusion, my reply was to the OP csad57. But wishing you the best with upcoming tests
@copyman
My reply was to suggest that a CT scan might be just as useful as a MRI scan.
Get a second opinion at a “center for excellence “ - consider after effects and ability to treat for cancer if it shows up later.
TLDR;
This stuff can be confusing but mine was surgically removed due to cancer. But you don’t have cancer, you have lesions. Are they pre-cancerous?
What about the non removal methods to get a smaller prostate?
Have you read about lifestyle changes after surgical removal? This is major surgery. Just the lifting over 10 lbs is 8 weeks.
Do they really cut the urethra? Asking because they absolutely do with surgical removal (robotic, through abdomen thank goodness)
The second opinion - at a center for excellence is gold. My local urologist is stuck in the 1980s and once shouted at me - “robotic!? I have been doing this for 35 years.”
I stood up, said “and that’s the problem” and left. Went to Mayo but there are other centers for excellence.
I'm not sure there are "Centers For Excellence" here in Idaho...
Yes lesions but no cancer but that was 2-3 years ago..who knows whats in there now... thats why I want to check for cancer again...before doing anything
Through the penis was what the PA said...maybe he was trying to scare me LOL did a good job
Yea my boss isn't happy about light duty for that long... I'm a Maint. Tech at a Rehab Hospital..
@casd57 Through the penis (other than Tulsa Pro) is just for BPH, not cancer. TURP, HoLEP, Aquablation, Rezum (steam), and green laser are various methods of reducing urethra constraints / prostate size through the penis. Some of these are surgery (like TURP), others minimal invasive and can be done at doctor office. Nearest CoE would be Fred Hutch (UW, Seattle). Real RP is major surgery. Even with robot have 1 (new) or 5 incisions and a lot of recovery time plus a high risk of side effects (most are incontinent for at least the first few months after surgery).
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3 ReactionsSorry to hear about your situation. If you do not have cancer I would not remove the prostate. (My opinion only)
I would definitely get a second opinion. Best advice!
Maybe discuss with your urologist on having a PSMA PET to see if it will offer a better view of any potential issues. (My understanding and situation was the PET scan was able to show cancer in my prostate that was not shown up on MRI. )
They went back to the MRI and did see it but it's was very hard to see.
Their is a lot of good information here from others with options.
I would recommend putting your information into AI and ask for recommendation and questions to ask your urologist. It is a great tool for guidance but ultimately nothing can beat an experienced urologist.
Ask to speak with hospital about offering a reduced rate since you are out of pocket. No idea if it will work but you never know,
Good luck!
@casd57
I checked the NCCN and NCI list of centers of excellence and nothing in Idaho is listed.
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1 Reaction@payner
One of the factors that was pushing me to get this done was because of the 3 ER visits...the optilume done i have hit my max out of pocket for the year, so at this point everything is 100% paid until January
But still no cancer is a no go for me..
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1 ReactionI told the Doctor..yesterday that before we proceed..i want to check for cancer
His reply was:
Because your doing better and responding to finasteride well i think ill have you come back in 6 months for a blood draw ..PSA and go from there..
Okay now my opion is this ...he didnt think the removal was necessary at this time also...
It almost felt like he had a sly of relief because he was so fast at stopping for 6 months..with no argument..or anything..
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1 Reaction@casd57 It looks like you are dealing with small town Urologist(s), doctors. Since there are no "centers of excellence" in your state that you could travel to I would at least consider doing a video consult with a top prostate doc. A few that come to mind are Dr Scholz, Dr Chang, etc. You could send them your records then after they review records do a virtual consult with them. Insurance should cover the consult with most doctors but with Dr Scholz there is an extra membership fee good for a year where he will have a consult with you once a month to keep up with everything. Dr Scholz has many great prostate videos for free on youtube.
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